title: Atrial fibrillation linked to vascular access thrombosis in chronic hemodialysis patients.
abstract: OBJECTIVE
  Atrial fibrillation (AF) is characterized by the development of thromboembolic events and is more prevalent among end-stage renal disease patients than in the general population. Vascular access thrombosis (VAT) is a major morbidity in chronic hemodialysis (HD) patients; however, the association between AF and VAT is unknown.
  
  
  METHODS
  We retrospectively reviewed chronic HD patients with functional vascular access between 1997 and 2006. The association between AF and the development of VAT was analyzed using Kaplan-Meier analysis and multivariate Cox proportional hazards regression.
  
  
  RESULTS
  A total of 568 chronic HD patients, including 55 (9.7%) patients with AF, were reviewed and 154 (27.1%) patients developed at least one episode of VAT. Patients with AF had worse VAT-free survival than patients without AF (p< 0.001). In Cox regression, age, type of vascular access, atrial fibrillation, diabetes, hypertension, and C-reactive protein were independently linked to the development of VAT ( p= 0.049, < 0.001, < 0.001, 0.001, 0.028 and 0.045). The hazard ratios were 2.1 (95% CI: 1.00-1.03) for arteriovenous graft, 2.47 (95% CI: 1.66-3.69) for AF, 1.72 (95% CI: 1.25-2.39) for diabetes and 1.09 (95% CI: 1.00-1.18) for serum C-reactive protein (every 1 mg/dL increase), respectively.
  
  
  CONCLUSIONS
  Atrial fibrillaiton is linked to the development of vascular access thrombosis in chronic hemodialysis patients and is independent of traditional VAT risk factors.
authors.affiliation: Institute and Division of Nephrology, China Medical University Hospital, Taiwan.
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Chou
authors.forename: Jan-Yow
authors.initials: JY
authors.lastname: Chen
authors.forename: Jiung-Hsiun
authors.initials: JH
authors.lastname: Liu
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Liu
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Lin
authors.forename: Ya-Fei
authors.initials: YF
authors.lastname: Yang
authors.forename: Shu-Ming
authors.initials: SM
authors.lastname: Wang
authors.forename: Huey-Liang
authors.initials: HL
authors.lastname: Kuo
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
mesh_terms: D001281:Atrial Fibrillation / Q000209:etiology*; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology*
chemical_list: D002097:C-Reactive Protein